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Shoulder Arthritis Symptoms and Treatment QA
My name is Uma Srikumaran. I'm an orthopedic surgeon with Johns Hopkins and Howard County General . I specialize in shoulder surgery. Shoulder arthritis refers to degeneration of thelining of the joint. The lining of the joint is made of smooth cartilage thatcan wear out over time or can be diseased by inflammatory conditions such asrheumatoid arthritis or from a traumatic condition or posttraumatic arthritisafter a shoulder dislocation. The typical wear and tear arthritis iscalled osteoarthritis.
Pain is the most common symptom of shoulder arthritis. Pain can occur throughout the day and worsen with certain activities.ing and catching may also be noticed coming from the shoulder. As arthritisprogresses the pain and stiffness will progress as well. Nonsurgical treatment for shoulder arthritisincludes simple measures such as rest and activity modifications or avoidingactivities that are painful for your shoulder. Nonsteroidal antiinflammatorymedications can also be beneficial for pain relief.
Other options include icing, physicaltherapy and cortisone injections that may also provide symptomatic relief. When nonsurgical treatments fail toprovide pain relief over a period of time or the pain becomes unbearable,surgical shoulder replacement surgery is an option. The goals of shoulder replacement surgery are pain relief as well as improved function so you may resume everydayactivities. The surgery is performed under generalanesthesia often with a nerve block
and involves an open incision in front ofyour shoulder. The arthritic bone is carefully removedalong with scar tissue and a metal prosthesis and a plastic component are inserted torecreate the ball and socket joint of the shoulder. Recovery after shoulder replacement surgery involves a one to two day admission. After this, an outpatient physicaltherapy program is performed usually beginning at two weeks aftersurgery and extending for several months. During this period patients are providedpain medications. Physical therapy will progress overseveral months. At first the therapist will
guide the patient on passive range ofmotion exercises followed by active range of motion exercises in which the patientperforms themselves. After a range of motion has been restored, strengthening exercisescan begin.
Rotator Cuff Injuries and Treatment for Shoulder Pain QA
My name is Uma Srikumaran. I'm an orthopedic surgeon with Johns Hopkins. and Howard County General . I specialize in shoulder surgery. The rotator cuff is a set of four musclesand tendons that attach the shoulder blade. to the proximal part of your arm or the proximal humerus. It serves to stabilize the shoulder and socket. and also helps lift and rotate your arm.
Common injuries to the rotator cuff include inflammation of the tendon itself. or the surrounding tissue, called rotator cufftendonitis or subacromial bursitis. or more significant injuries such as tears. These tears can be small or partial in size. or they can involve the entire tendon's full thickness and be quite large. They occur because of wear tear as we age or from acute traumaticinjuries. Treatment for rotator cuff tears caninvolve simple measures such as rest
and activity modification to avoidingactivities that are painful for your shoulder .to things like physical therapyand icing your shoulder and. pain medications such as antiinflammatorymedications like ibuprofen and aspirin. Surgery is a good option for treatment ofrotator cuff tears when nonsurgical measures such as physical therapy andpain medications have failed to provide. symptomatic relief over a period of time.
Other reasons for surgery include alarge tear. or tears that are resulted from an acute traumatic injury. Finally, if you have a high. demand occupation that requires a lot ofoverhead shoulder activity, this may be another reason to consider surgicalfixation. So, the surgery is typically performedarthroscopically although an open incision may be needed in rare cases. The arthroscopic approach uses smallincisions around your shoulder to insert
a camera and arthroscopic equipment toperform the work. The goals of surgery are to remove inflammation, remove diseasedportions of the rotator cuff and repair the rotator cuff tendon back into bone. Recovery after surgery can be lengthyand can progress over several months. Typically the patient will be in a slingfor four to six weeks after surgery and physical therapy will begin two to fourweeks after surgery and continue over several months. Physical therapy is usuallyindividualized and prescribed by the
surgeon after the surgery is performed. In general, however, the patient startswith passive range of motion exercises wheremotion is generated by the therapist and later towards active range of motionwhere the patient performs the range of motion exercises. After range of motion has returned,strengthening exercises can begin. The prognosis for rotator cuff repairs isexcellent, particularly in terms of pain relief.